Variability and clinical value of troponin T levels in diabetic kidney disease patients treated with di-alysis
Objective To determine the variation of troponin T(TnT)in diabetic kidney dis-ease(DKD)patients treated with dialysis,and to evaluate its clinical value.Methods A total of 8,553 DKD patients treated with dialysis and examination of TnT values were screened in Jinan Central Hospi-tal from January 1,2014 to August 31,2020.Screened by inclusion and exclusion criteria,5,692 pa-tients were excluded.After excluding 2,485 cases with unavailable TnT data,finally,376 eligible pa-tients were included into our study.They were divided into DKD dialysis group and non-DKD(NDKD)dialysis group based on the primary disease.Baseline TnT was compared between the two groups,and the optimal threshold to diagnose acute myocardial infarction was determined by plotting the receiver oper-ating characteristic(ROC)curves.Influencing factors for baseline TnT in DKD patients treated with di-alysis and their correlation with poor prognosis were analyzed.Results Baseline TnT in the DKD dialy-sis group(267.27 ng/L)was significantly higher than that in the NDKD dialysis group(76.09 ng/L),which was 3.51 times higher.The optimal threshold of baseline TnT for the diagnosis of acute myocar-dial infarction was 166.85 ng/L in NDKD dialysis group,and 367.45 ng/L in DKD group.Higher base-line TnT were detected in men than women in the DKD dialysis group.Baseline TnT was positively as-sociated with age,degree of DKD,and degree of lower extremity vasculopathy,but negatively corre-lated with hemoglobin and albumin.With the increase in baseline TnT,the rate of myocardial infarction,psychogenic mortality,diabetic foot ulcer,and all-cause mortality increased in DKD dialysis group.Con-clusion Baseline TnT is significantly higher in the DKD dialysis group than that of the NDKD dialysis group,and a higher threshold is required for the diagnosis of acute myocardial infarction.Elevated base-line TnT level is influenced by factors such as diabetic vascular complications,which can be used as a prognostic indicator for adverse events.
NETL
NSTL
万方数据
